Oleksandr B. Superior-septal approach in mitral valve surgery

The dissertation is dedicated to the problem of a difficult mitral valve (MV) exposure during MV surgery and is focused on the elaboration and introduction of the efficacious surgical methods to overcome the problem. The dissertation consists of two parts - experimental and clinical. The comparison of MV exposure with the different approaches to the MV was done on corpses (experimental part) by means of determining the geometric criteria to demonstrate and evaluate quantitavely the advantage of superior-septal approach (SSA). The clinical part consisted of the analysis of 927 operation on MV, among them - 130 cases with SSA. The inadequate exposure of the MV as a cause of traumatic and technical complications was studied. The efficacy of SSA in reducing traumatic operative complications was established. The improved results of MV replacement was obtained with the use of SSA during redo MV operation. The method of selective extension of MV approach in case of inadequate exposure was proposed.